CAJ | 학술논문

目的:研究胃癌患者术前血小板计数与其手术后预后的关系.方法:回顾性分析天津医科大学附属肿瘤医院1995年1月至1999年12月间,经手术治疗的胃癌初治患者782例临床资料并进行随访,比较血小板增高情况对患者生存预后的影响,应用Kaplan-Meier法进行生存分析并行Log-rank检验,Cox多因素回归分析患者血小板增高及其他临床因素对预后的影响.结果:本组胃癌患者血小板增高发生率为11.4%(89/782),血小板增高发生率在不同性别、临床分期及组织分化之间差异无统计学意义(P>0.05),仅在不同年龄之间差异存在统计学意义(P<0.05).无血小板升高与血小板升高的患者1、3、5年生存率分别为75.0%vs 52.8%(P<0.0t)、40.1%vs 16.9%(P<0.01)、28.9%vs 13.5%(P=0.002).单因素分析显示,临床组织分化类型、病理分期、手术方式显著影响患者生存,而年龄、性别对生存期无显著影响.进一步多因素分析显示,临床分期、手术方式及血小板计数是影响预后的独立因素,血小板升高的患者相对危险度(RR=1.454,95%CI:1.135～1.861,P=0.005)表明血小板升高患者死亡危险为血小板无升高者的1.454倍.结论:血小板增高是影响胃癌初治患者生存的独立预后因素.
목적:연구위암환자술전혈소판계수여기수술후예후적관계.방법:회고성분석천진의과대학부속종류의원1995년1월지1999년12월간,경수술치료적위암초치환자782례림상자료병진행수방,비교혈소판증고정황대환자생존예후적영향,응용Kaplan-Meier법진행생존분석병행Log-rank검험,Cox다인소회귀분석환자혈소판증고급기타림상인소대예후적영향.결과:본조위암환자혈소판증고발생솔위11.4%(89/782),혈소판증고발생솔재불동성별、림상분기급조직분화지간차이무통계학의의(P>0.05),부재불동년령지간차이존재통계학의의(P<0.05).무혈소판승고여혈소판승고적환자1、3、5년생존솔분별위75.0%vs 52.8%(P<0.0t)、40.1%vs 16.9%(P<0.01)、28.9%vs 13.5%(P=0.002).단인소분석현시,림상조직분화류형、병리분기、수술방식현저영향환자생존,이년령、성별대생존기무현저영향.진일보다인소분석현시,림상분기、수술방식급혈소판계수시영향예후적독립인소,혈소판승고적환자상대위험도(RR=1.454,95%CI:1.135～1.861,P=0.005)표명혈소판승고환자사망위험위혈소판무승고자적1.454배.결론:혈소판증고시영향위암초치환자생존적독립예후인소.
Objective: To analyze the association of thrombocytosis with the prognosis of patients with gastric cancer.Methods: The clinical materials of 782 patients with gastric cancer who underwent initial surgery in our hospital between January 1995 and December 1999 were retrospectively analyzed.Kaplan- Meier and Log-Rank test were used to analyze the data.Prognostic factors were analyzed by multivariate Cox proportional hazards model.Results: Thrombocytosis oc-curred in 11.4% (87/782) patients.The platelet level was not significantly different among patients of different gender, tumor stage, and histological differentiation (P>0.05).However, a significant difference was observed in the platelet level among patients with different age and surgical approach (P<0.05).The 1-, 3-, and 5-year survival rates were 75.0%, 40.1% and 28.9% in patients without thrombocytosis and 52.8%, 16.9%, and 13.5% in patients with thrombocytosis (P=0.002).Univari-ate analysis showed that histological differentiation, pathological stage, surgical approach and thrombocytosis significantly affected the survival of patients.While age and gender had no significant impact on patient survival.Multivariate analysis showed that pathological stage, surgical approach, and thrombocytosis were independent prognostic factors for gastric can-cer.The relative risk of death of patients with thrombocytosis was elevated by 1.454 times (RR=1.454, 95% CI: 1.135～1.861, P=0.005).Conclusion: Thrombocytosis is an independent prognostic indicator for the survival of initially treated pa-tients with gastric cancer.